It is common for adults who provide care for family members to experience guilt.  I talked recently to Jeannie, a woman who assists with cooking, managing medications, and shopping for her octogenarian mother.  As she got ready to leave her mother’s apartment a few days ago, her mother said in a plaintive voice, “You don’t have to leave yet, do you?”  Jeannie did have to leave.  “I went,” she told me, “but I felt so guilty.”

Why do we feel guilty in such situations?  Luann Smith, who blogs at My Elder Care Consultant, LLC, defines guilt as “feelings of culpability especially for imagined offenses or from a sense of inadequacy.”   Such a definition separates guilt from any actual wrongdoing and characterizes it as maladaptive.  Smith adds that guilt can “really paralyze children of aging parents and lead you to make decisions based in fear and toxic emotions not healthy ones.”  This certainly can happen—I know one woman who, because she felt  guilty, neglected her own health problems to sit with her father day after day, even though he was cared for well in an assisted living facility. This woman did indeed have a strong sense of inadequacy, a factor that Smith includes in her definition.

Is guilt inherently maladaptive, though?  Dictionary.com defines guilt as a violation of standards; it’s “the fact or state of having committed an offense, crime, violation, or wrong, especially against moral or penal law.”  The emotional aspect of guilt is the second definition listed: “a feeling of responsibility or remorse for some offense, crime, wrong, etc., whether real or imagined.”   Some caregivers for the elderly are actually guilty of misconduct, such as physical abuse or taking possessions without permission.   Feelings of guilt for such violations are not only acceptable but desirable.   We tend to think poorly of those who exploit elders without experiencing any guilt.

Of course many offenses are minor, or may not be offenses at all, or provoke guilt out of proportion to the degree of offense.  Is guilt still a useful emotion then?  I stay with my parents to help provide care for my 89-year-old dad, who has dementia.  A few weeks ago, he wasn’t sleeping well and woke me up several times.  The last time, when he called me to say his leg muscles were sore, I showed no sympathy for his aches and told him gruffly to stop calling me.  I felt a little guilty afterwards, and put more effort into being patient with him the next night.  I think my low-level guilt was appropriate to my low-level offense.  Rather than causing poor decision-making, guilt actually helped me respond more in line with how I wanted to.

Excessive or unwarranted guilt can be a problem; I’ll write later about why caregivers may be prone to such guilt and what to do about it.  I’ll end this post by noting that there is research to support the connection between experiencing guilt and acting morally.  In their book Shame and Guilt, June Price Tangney and Ronda L. Dearing report that fifth graders who were more guilt-prone than their peers were less likely as adolescents to violate societal rules and use drugs, but were more likely to apply to college and become involved in community service.  Exactly the opposite pattern was found with children who had high levels of shame.  It seems that shame, not guilt, is the moral emotion most associated with poor choices and undesirable behavior.